Healthcare Provider Details

I. General information

NPI: 1790332617
Provider Name (Legal Business Name): SARAH M SERRAO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH M HEMMINGER NP

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6110 RADIO WAY
MASON OH
45040-4520
US

IV. Provider business mailing address

7835 PARAGON RD
DAYTON OH
45459-4021
US

V. Phone/Fax

Practice location:
  • Phone: 513-701-5526
  • Fax: 513-701-5979
Mailing address:
  • Phone: 937-436-4146
  • Fax: 937-530-4083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.025518
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: